<html>
<head>
<title>The Autism Spot</title>


<link rel="stylesheet" href="css/autism.css" type="text/css" />
</head>
<body>
<div id="pagewidth" >
	<div id="header" ><strong>
		<h1 align="center"> Autism Society of America - Greater Georgia Chapter</strong></h2></div>
			<div id="wrapper" >
		<div id="twocols" >
			<div id="maincol">
			<h2>The Autism Spot</h2>
			<form action="autism.html" method="post">

			        <table id="table" width="100%" border="0">
			            <tr>
							<td><div align="right">First Name:</div></td>
							<td><input type="text" name="fname" value="Scott">
							</td>
			            </tr>
			            <tr>
			                <td><div align="right">Last Name:</div></td>
			                <td><input type="text" name="lname" value="Bales">
			                </td>
			            </tr>
			            <tr>
			                <td><div align="right">Address1:</div></td>
			                <td><input type="text" name="address1" value="2971 Flowers Road">
			                </td>
			            </tr>
			            <tr>
							<td><div align="right">Address2:</div></td>
							<td><input type="text" name="address2" value="Suite 100">
							</td>
			            </tr>
			            <tr>
			                <td><div align="right">City:</div></td>
			                <td><input type="text" name="city" value="Atlanta">
			                </td>
			            </tr>
			            <tr>
			                <td><div align="right">State:</div></td>
			                <td><input type="text" name="state" maxlength="2" value="GA">
			                </td>
			            </tr>
			            <tr>
			            <td><div align="right">Zip:</div></td>
			            <td><input type="text" name="zip" value="30341"></td>
			            </tr>
			            <tr>
			            <td><div align="right">Phone:</div></td>
			            <td><input type="text" name="phone" value="404-463-3875"></td>
			            </tr>
			            <tr>
			            <td><div align="right">Cell Phone:(optional)</div></td>
						 <td><input type="text" name="cphone" value="404-388-1358"></td>
			            </tr>
			            <tr>
			            <td><div align="right">Email:</div></td>
			            <td><input type="text" name="email" value="gismas@bellsouth.net">
			            </td>
			             <tr>
							<td><div align="right">Password</div></td>
							<td><input type="text" name="pass1" value="Gis06!"></td>
						</tr>
						<tr>
							<td><div align="right">ReType Password</div></td>
							<td><input type="text" name="pass2" value="Gis06!"></td>
			            </tr>
			            <tr>
			                <td><div align="right"></div></td>
			                <td><input type="submit" value="Continue" name="continue">
			                </td>
			            </tr>
			        </table> </form>
			        <br>



</div>
</div>
	<div id="footer"><p align="center"><strong>Created for the Autism Society of America - Greater
	Georgia Chapter by UGA MIT Students</p></strong>
	</div>
	</div>
</body>
</html>